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Nursing 2 > Joint & Connective Tissue > Flashcards

Joint & Connective Tissue Flashcards

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1
Q

assessment for joint/connective tissue problems include

A

gait, posture, functional assessment (observe activities like transfer to chair, dressing/ADL)

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2
Q

ESR is

A

rate of sedimentation of RBC, inflammation causes clumping of RBC so higher ESR level an indication of inflammation

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3
Q

antiarthritic drugs: 3 categories

A
  1. NSAIDs, non-steroidal anti inflammatory drugs including aspirin
  2. DMARDs disease modifying anti rheumatic drugs
  3. glucocorticoids - adrenal corticosteroids
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4
Q

inflammatory connective tissue diseases: 3

A
  1. RA
  2. SLE (systemic lupus erythematosus
  3. Scleroderma
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5
Q

serum lab tests:

A
  1. ESR
  2. Uric Acid
  3. ANA (antinuclear antibody)
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6
Q

3 goals of rheumatic disease

A
  1. suppress inflammation and the autoimmune response
  2. control pain
  3. maintain or improve joint mobility
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7
Q

osteoarthritis definition

A

chronic, causes cartilage deterioration in synovial joints and vertebrae.

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8
Q

osteoarthritis affects

A

weight bearing joints: hips and knees

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9
Q

osteoarthritis pain: when?

A

worse with activity, better with rest, not usually at night

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10
Q

crepitus during ROM activity

A

sign of OA

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11
Q

herberden: definition

A

enlarged upper joints of the fingers/DIP joints

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12
Q

bouchard: definition

A

enlarged lower joints of the fingers/PIP joints

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13
Q

radiographic/X Rays show

A

osteophytes - (bone spur) bony growth at the end of a bone

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14
Q

MRI show

A

cartilage, synovium and bone

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15
Q

osteoarthritis interventions:

A

no treatment to stop degeneration of joints so

  1. educate
  2. reduce pain and inflammation
  3. maintain function
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16
Q

NSAID risk

A

GI complications

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17
Q

arthroplasty and osteoarthritis:

A

surgical repair of the joint

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18
Q

intra-articular injections

A

hyaluronic acid - acts as synovial fluid in joint space

corticosteroids - methylprednisolone

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19
Q

hot or cold treatment timing

A

20 minutes on/off

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20
Q

gout: definition

A

urate crystals deposited in joints, problem with purine metabolism > hyperuricemia (high uric acid in blood)

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21
Q

primary gout: definition

A

genetic, overproduction of uric acid or decreased urate excretion in the kidney

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22
Q

secondary gout definition

A

also hyperuricemia, diabetic ketoacidosis (DKA), starvation

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23
Q

tophi: definition

A

urate/uric acid crystals deposited in peripheral areas like great toe, hands or ear.

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24
Q

acute gouty arthritis: definition

A

recurrent attacks of joint inflammation/ acute arthritis

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25
Q

diagnostics for gout: 4

A
  1. uric acid test, 6.8 is gout
  2. 24 hour urine collection
  3. x-ray
  4. aspiration of fluid from inflamed joint to see crystals
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26
Q

gout ice or heat?

A

ice

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27
Q

gout medications

A

chochicine (colcrys) - interfere with function of WBC so no inflammatory response

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28
Q

chochicine (colcrys) side effects

A

diarrhea, take with meals,

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29
Q

gout nursing interventions

A
  1. pain mgmt - cold compression
  2. hydration - avoid kidney stones
  3. diet - avoid pureens (organ meat, alcohol, red meat)
  4. healthy weight
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30
Q

rheumatoid arthritis unilateral?

A

no, affects both sides at same time

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31
Q

RA sign

A

morning stiffness for an hour before pain

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32
Q

RA causes

A
  1. rheumatoid factor (RF) antibodies form against IgG

2. synovial membrane destruction leads to pannus

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33
Q

RA signs

A

deformities of hands and feet
fatigue
weight loss
Raynaud’s

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34
Q

arthrocentesis

A

RA diagnostic, synovial fluid analysis

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35
Q

swan neck deformity

A

deformed position of the finger due to RA

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36
Q

RA labs

A 
RF high
Anti CCP high
ESR high
ANA high
RBC lower
37
Q

DMARDs

A

methotrexate - anti inflammatory, give with folic acid supplement, s/e aplastic anemia

38
Q

saline eye drops for

A

RA

39
Q

connective tissue types include

A

bone, blood and organs

40
Q

ESR diagnose? evaluate treatment?

A

not to diagnose, evaluate

41
Q

intercritical symptoms?

A

no

42
Q

gout in the great toe called

A

podagra

43
Q

uric acid level signals gout

A

6.8

44
Q

gout and kidney stones (uric acid filtered by kidneys)

A

purines make up 15 percent of uric acid, uric acid > gout and kidney stones

45
Q

colchicine/Colcrys timing

A

must be taken within 24 hours of onset of acute gout attack

46
Q

XOI (Xanthine Oxidase Inhibitors) treat

A

gout by blocking uric acid formation

47
Q

XOI side effects

A

anti diabetes meds: hypotension, hypoglycemia

48
Q

Uricosuric treat

A

gout by lower/inhibit renal reabsorption of uric acid so excreted out in urine, decrease serum uric acid

49
Q

Uricosuric risk

A

kidney stones

50
Q

Uricosuric not to be taken with

A

aspirin and thiazide diuretics

51
Q

gout hydration amount and reason

A

2L to prevent kidney stones

52
Q

osteoarthritis level of activity

A

moderate

53
Q

osteoarthritis s/s

A

stiff joints b/c loss of synovial fluid
crepitus
no inflammation
worse pain bad weather

54
Q

osteoarthritis and WBC

A

WBC WNL b/c no systemic inflammation, just local swelling

55
Q

osteoarthritis assessment

A

morning stiffness: 30 minutes

56
Q

tylenol / acetaminophen

A

max 4000 mg/ 4g

57
Q

osteoarthritis hot or cold

A

temperature treatments hot and cold

58
Q

osteoarthritis meds

A

COX2 Inhibitors / celecoxib / celebrex for local inflammation

59
Q

COX2 Inhibitors / celecoxib / celebrex side effects

A

cardiovascular problems, MI, CVA, high BP

60
Q

autoimmune local?

A

systemic

61
Q

systemic example

A

dry mucus membranes, wrist pain, cold feet

62
Q

RA unilateral

A

bilateral

63
Q

RA assessment

A

morning stiffness 1 hour

64
Q

Rheumatoid Factor RF specific to RA

A

no, all inflammation have high RF

65
Q

arthrocentesis fluid color

A

synovial fluid s/b clear, not cloudy or milky (b/c antibodies in it)

66
Q

any med that treats inflammation risk

A

infection b/c WBC inhibited

67
Q

Tumor Necrosis Factor (TNF) treat

A

RA

68
Q

Tumor Necrosis Factor (TNF) side effects

A

TB so manteaux test before, no live vaccines

69
Q

dairy and inflammation

A

can cause it

70
Q

SLE risk factors

A

15-40 YO, black and hispanic women,

71
Q

SLE cause

A

anti-DNA antibodies, blood vessels attacked/inflamed

72
Q

SLE and kidneys

A

lupus nephritis

73
Q

SLE and skin

A

rash, photosensitivity, butterfly rash,

74
Q

Scleroderma definition

A

connective tissue disease, hardening of the skin

75
Q

Scleroderma effects

A

loss of skin elasticity incl lungs, esophagus and GI tract hardening

76
Q

Scleroderma interventions

A

impaired swallowing and constipation

77
Q

RA s/s

A

bilateral joint pain, weight loss, joint deformed, tinnitus, GERD

78
Q

SLE s/s

A

fever, nephritis

79
Q

ANA serum test to

A

diagnose

80
Q

ESR blood test to

A

evaluate treatment

81
Q

pannus is

A

highly vascular granulation tissue

82
Q

SLE usually linked to

A

Scleroderma

83
Q

Rheumatoid Arthritis (RA) vs Osteoarthritis (OA) similarities

A
  1. RA and OA both forms of arthritis which is pain in the joints
  2. both chronic
  3. both
84
Q

RA vs OA type of disease

A

RA autoimmune

OA “wear and tear” over time, degenerative, destroys cartilage in synovial joints and vertebrae

85
Q

RA vs OA symptoms

A

RA joint pain, inflammation, stiffness

OA joint pain, non inflammatory, stiffness

86
Q

RA vs OA location

A

RA inflammation in pairs of smaller joints, both hands, both ankles, etc
OA weight bearing joints (back, hip, knee)

87
Q

RA vs OA timing

A

RA worse in morning for at least 1 hour

OA morning for 30 minutes, gets worse with activity during day

88
Q

RA vs OA systemic symptoms

A

RA, systemic fatigue, weight loss, weakness

OA, localized

Nursing 2 (9 decks)

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